Abstract
Objective: Whereas several studies have used functional magnetic resonance imaging (fMRI) to investigate motor recovery, whether therapy to decrease post-stroke hypertonus alters central motor patterns remains unclear. In this study, we used continuous electromyography (EMG)-fMRI to investigate possible changes in movement-related brain activation in patients receiving Botulinum toxin (BoNT-A) for hand-muscle hypertonus after chronic stroke. Methods: We studied eight stroke patients all of whom had hemiparesis and associated upper-limb hypertonus. All patients underwent an fMRI-EMG recording and clinical-neurological assessment before BoNT-A and 5 weeks thereafter. The handgrip motor task during imaging was fixed across both patients and controls. The movements were metronome paced, movement amplitude and force were controlled with a plastic orthosis, dynamometer and EMG recording. An age-matched control group was recruited from among healthy volunteers underwent the same fMRI-EMG recording. Results: Before BoNT-A, while patients moved the paretic hand, fMRI detected wide bilateral activation in the sensorymotor areas (SM1), in the supplementary motor area (SMA) and cerebellum. After BoNT-A blood oxygenation level-dependent (BOLD) activation decreased in ipsilateral and contralateral motor areas and became more lateralized. BOLD activation decreased also in ipsilateral cerebellar regions and in the SMA. Conclusion: Changes in peripheral upper-limb hypertonus after BoNT-A were associated to an improvement in active movements and more lateralized and focalized activation of motor areas. The clinical and EMG-fMRI coregistration technique we used to study hand-muscle hypertonus in patients receiving BoNT-A after chronic stroke should be useful in future studies seeking improved strategies for post-stroke neurorehabilitation.
| Original language | English |
|---|---|
| Pages (from-to) | 646-652 |
| Number of pages | 7 |
| Journal | Magnetic Resonance Imaging |
| Volume | 28 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - Jun 2010 |
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Keywords
- Botulinum toxin
- EMG
- FMRI
- Spasticity
- Stroke
ASJC Scopus subject areas
- Biophysics
- Radiology Nuclear Medicine and imaging
- Biomedical Engineering
- Medicine(all)
Cite this
Changes in cerebral activity after decreased upper-limb hypertonus : An EMG-fMRI study. / Manganotti, Paolo; Acler, Michele; Formaggio, Emanuela; Avesani, Mirko; Milanese, Franco; Baraldo, Andrea; Storti, Silvia Francesca; Gasparini, Anna; Cerini, Roberto; Mucelli, Roberto Pozzi; Fiaschi, Antonio.
In: Magnetic Resonance Imaging, Vol. 28, No. 5, 06.2010, p. 646-652.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Changes in cerebral activity after decreased upper-limb hypertonus
T2 - An EMG-fMRI study
AU - Manganotti, Paolo
AU - Acler, Michele
AU - Formaggio, Emanuela
AU - Avesani, Mirko
AU - Milanese, Franco
AU - Baraldo, Andrea
AU - Storti, Silvia Francesca
AU - Gasparini, Anna
AU - Cerini, Roberto
AU - Mucelli, Roberto Pozzi
AU - Fiaschi, Antonio
PY - 2010/6
Y1 - 2010/6
N2 - Objective: Whereas several studies have used functional magnetic resonance imaging (fMRI) to investigate motor recovery, whether therapy to decrease post-stroke hypertonus alters central motor patterns remains unclear. In this study, we used continuous electromyography (EMG)-fMRI to investigate possible changes in movement-related brain activation in patients receiving Botulinum toxin (BoNT-A) for hand-muscle hypertonus after chronic stroke. Methods: We studied eight stroke patients all of whom had hemiparesis and associated upper-limb hypertonus. All patients underwent an fMRI-EMG recording and clinical-neurological assessment before BoNT-A and 5 weeks thereafter. The handgrip motor task during imaging was fixed across both patients and controls. The movements were metronome paced, movement amplitude and force were controlled with a plastic orthosis, dynamometer and EMG recording. An age-matched control group was recruited from among healthy volunteers underwent the same fMRI-EMG recording. Results: Before BoNT-A, while patients moved the paretic hand, fMRI detected wide bilateral activation in the sensorymotor areas (SM1), in the supplementary motor area (SMA) and cerebellum. After BoNT-A blood oxygenation level-dependent (BOLD) activation decreased in ipsilateral and contralateral motor areas and became more lateralized. BOLD activation decreased also in ipsilateral cerebellar regions and in the SMA. Conclusion: Changes in peripheral upper-limb hypertonus after BoNT-A were associated to an improvement in active movements and more lateralized and focalized activation of motor areas. The clinical and EMG-fMRI coregistration technique we used to study hand-muscle hypertonus in patients receiving BoNT-A after chronic stroke should be useful in future studies seeking improved strategies for post-stroke neurorehabilitation.
AB - Objective: Whereas several studies have used functional magnetic resonance imaging (fMRI) to investigate motor recovery, whether therapy to decrease post-stroke hypertonus alters central motor patterns remains unclear. In this study, we used continuous electromyography (EMG)-fMRI to investigate possible changes in movement-related brain activation in patients receiving Botulinum toxin (BoNT-A) for hand-muscle hypertonus after chronic stroke. Methods: We studied eight stroke patients all of whom had hemiparesis and associated upper-limb hypertonus. All patients underwent an fMRI-EMG recording and clinical-neurological assessment before BoNT-A and 5 weeks thereafter. The handgrip motor task during imaging was fixed across both patients and controls. The movements were metronome paced, movement amplitude and force were controlled with a plastic orthosis, dynamometer and EMG recording. An age-matched control group was recruited from among healthy volunteers underwent the same fMRI-EMG recording. Results: Before BoNT-A, while patients moved the paretic hand, fMRI detected wide bilateral activation in the sensorymotor areas (SM1), in the supplementary motor area (SMA) and cerebellum. After BoNT-A blood oxygenation level-dependent (BOLD) activation decreased in ipsilateral and contralateral motor areas and became more lateralized. BOLD activation decreased also in ipsilateral cerebellar regions and in the SMA. Conclusion: Changes in peripheral upper-limb hypertonus after BoNT-A were associated to an improvement in active movements and more lateralized and focalized activation of motor areas. The clinical and EMG-fMRI coregistration technique we used to study hand-muscle hypertonus in patients receiving BoNT-A after chronic stroke should be useful in future studies seeking improved strategies for post-stroke neurorehabilitation.
KW - Botulinum toxin
KW - EMG
KW - FMRI
KW - Spasticity
KW - Stroke
UR - http://www.scopus.com/inward/record.url?scp=77952959568&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77952959568&partnerID=8YFLogxK
U2 - 10.1016/j.mri.2009.12.023
DO - 10.1016/j.mri.2009.12.023
M3 - Article
VL - 28
SP - 646
EP - 652
JO - Magnetic Resonance Imaging
JF - Magnetic Resonance Imaging
SN - 0730-725X
IS - 5
ER -